Uncovered Costs: How Federal Agencies’ Failure to Pay for Medical Exams Could Mask Discrimination

An issue overlooked by many federal agencies is their obligation under EEOC regulations to cover the expenses of certain medical evaluations for job applicants. This responsibility is particularly significant in roles demanding extensive physical exertion, such as law enforcement and other similar positions.

Many federal agencies have either misunderstood or haven’t adequately updated their policies, leading to potential legal complications and barriers for applicants, especially those with disabilities.

The crux of the matter lies in the agencies’ failure to update their policies, reflecting their responsibility to bear the costs of medical examinations they require from applicants. This oversight is not a trivial administrative error but a significant barrier and potentially leading to discrimination.

Particularly for applicants with disabilities or those transitioning from military service who might already face financial challenges, these individuals, aiming for positions with stringent medical prerequisites, often find themselves burdened with expenses that are, by law, not theirs to bear.

Understanding Your Rights: Medical Exams Post-Offer

The Rehabilitation Act prohibits federal agencies from requesting medical information or conducting examinations until they extend a conditional employment offer. Post-offer, agencies may mandate medical assessments to confirm an applicant’s ability to perform job-related functions.

This is common in physically demanding roles like law enforcement. This stage allows for assessing if reasonable accommodations are necessary for applicants with disabilities, without causing undue hardship to the agency. It also allows agencies to identify if applicants may create a safety risk due to medical conditions.

These safeguards, provided under the Rehabilitation Act, extend to all job applicants and employees, not just those with recognized disabilities. The Act ensures that no individual bears unfair financial burdens for mandatory medical examinations required during the hiring process, specifically after receiving a conditional job offer. There’s no prerequisite to identify as having a disability to exercise these rights.

Examining Levi P.’s Case: Medical Costs and Agency Evasion

A case that highlights this issue involved Levi P. and the Transportation Security Administration. The agency’s approach was to shift the responsibility for additional medical documentation onto the applicant, putting the application ‘on hold’ while waiting for specific medical examinations and information from the applicant.

The agency did not outright reject the applicant. Instead, the Agency made compliance with the request for further medical examinations ‘voluntary’. At the same time, it conditioned further consideration for the position on providing the results of the medical examination that the Agency would not pay for. The Agency thus sidestepped its obligation to fund the examination by calling the additional medical examinations ‘voluntary’ while in reality requiring these medical examinations.

In this case, however, the EEOC recognized the agency’s strategy as an evasion of its legal responsibilities. The EEOC clarified that by putting an application in limbo until it received further medical records, the agency was, in effect, insisting on these examinations. Consequently, the EEOC mandated that if the agency’s continuation of the application process depended on the outcomes of a medical examination, then the financial responsibility for that examination fell on the agency, not the applicant.

[T]he Agency was directed to revise its post-offer procedures to indicate that if it required an applicant at the post-offer stage to undergo a specific follow-up medical examination, the Agency would pay all costs associated with the follow-up examination. Upon review, we find the Agency has not complied with the clear and plain language set forth in the Commission’s Order.

Levi P. v. Dept. of Homeland Security (TSA), EEOC Case No. 0420160007 (2017).

This case underscores the subtleties in how agencies might attempt to evade legal requirements, demonstrating the necessity for applicants to be vigilant and informed about their rights.

Beyond the Surface: How Applicants often Bear the Cost of Discrimination

The implications of this are twofold. First, applicants already strained by the demanding nature of obtaining specific medical records, often not covered by insurance, are unjustly encumbered with additional financial strain. For many individuals, the cost of obtaining medical examinations, testing, and documentation is an enormous financial, as well as logistical strain in and scheduling doctors who would be willing to provide a medical–legal opinion.

Second, this practice opens the door for discrimination. An agency wishing to avoid hiring a person with a disability could impose strenuous medical documentation requirements, knowing well the individual might be unable to afford it. Instead of rejecting an employee because of a disability, which could be illegal, the agency simply relies on the lack of medical documentation keep the same discriminatory result.

Failure to hire an individual because of a disability is often illegal discrimination, unless the agency can show the individual poses a significant safety risk person is not capable of performing the essential functions of the job. To reject someone based on safety risks, the agency likely would have to show that the person meets the “direct threat” test, a complex medical-legal analysis of the person’s individual capabilities and risks of harm.

Applicants must recognize these nuances. Instances where applicants incurred examination costs or were rejected for not submitting medical documents could constitute a violation of the Rehabilitation Act. An agency’s omission to pay for required medical examinations, resulting in a decision not to hire, may amount to unlawful discrimination.

From Victim to Victor: Fighting Back as an Applicant

Applicants unlawfully required to finance their own medical examinations should be aware of potential remedies. Those who have incurred such costs may seek reimbursement from the concerned agency or lodge an EEO complaint, citing non-compliance with regulations mandating the agency cover these expenses.

Moreover, if an agency has denied employment due to the absence of medical records it did not fund, applicants can challenge this as a breach of the Rehabilitation Act. This assertion gains weight with the agency’s mandatory “direct threat” analysis, a critical evaluation to prevent bias in hiring decisions based on medical conditions.

Employees and applicants typically have 45 days to reach out to an EEO counselor at the hiring agency after a discriminatory decision. Filing a complaint can preserve your rights and allow you to hold the Agency responsible for medical examination costs or discrimination. For a clearer understanding of this process and your rights, discussing your experience with an attorney can also provide clarity on your situation and what to do next.

Given these nuances, consulting with a lawyer familiar with federal employment and the Rehabilitation Act is advisable. Navigating these issues alone can be overwhelming due to their legal complexities. Recognizing your rights is fundamental in combating discriminatory federal employment practices.


Levi P. v. Dept. of Homeland Security (TSA), EEOC Case No. 0420160007 (2017).

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